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The prognosis of neck residue nasopharyngeal carcinoma (NPC) patients: results from a case-cohort study.

ABSTRACT: Background: To assess the prognosis of neck residue nasopharyngeal carcinoma (NPC) patients and the efficacy of neck dissection in the treatment of these patients. Methods: We recruited 68 neck residue NPC patients. For each neck residue patient we had three matched NPC patients without neck residue as controls (n = 204). The primary endpoint was progression-free survival (PFS). The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs), and multivariable analysis was used to test the independent statistical significance of NPC patients. Results: Compared to controls, the neck residue patients showed significantly lower 3-year PFS (46.7% vs. 87.6%; P < 0.001). Multivariable analysis showed that neck residue was an independent prognostic factor for PFS. Conclusions: NPC patients who had pathologically proven neck residue are associated with poor prognosis. Management with neck dissection alone seems not to be sufficient for these patients.

SUBMITTER: Liu SL

PROVIDER: S-EPMC5968764 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The prognosis of neck residue nasopharyngeal carcinoma (NPC) patients: results from a case-cohort study.

Liu Sai-Lan SL Tang Lin-Quan LQ Chen Qiu-Yan QY Lin Huan-Xin HX Yang Qi Q Zhu Qian Q Wen Wen W Guo Shan-Shan SS Liu Li-Ting LT Li Yang Y Xie Hao-Jun HJ Tang Qing-Nan QN Sun Xue-Song XS Liang Yu-Jing YJ Li Xiao-Yun XY Yan Jin-Jie JJ Lin Chao C Lan Xiao-Wen XW Mai Hai-Qiang HQ Guo Ling L

Journal of Cancer 20180419 10

Background: To assess the prognosis of neck residue nasopharyngeal carcinoma (NPC) patients and the efficacy of neck dissection in the treatment of these patients. Methods: We recruited 68 neck residue NPC patients. For each neck residue patient we had three matched NPC patients without neck residue as controls (n = 204). The primary endpoint was progression-free survival (PFS). The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence ...[more]

PMID: 29805702

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Project description:BACKGROUND: To clarify the feasibility and efficacy of chemoradiotherapy (CRT) in elderly (age?65 years) patients with locoregionally advanced nasopharyngeal carcinoma (NPC). METHODS: From January 2000 to December 2006, 101 newly diagnosed elderly non-metastatic NPC patients (age?65 years) who received cisplatin 3-weekly or weekly concurrent CRT with/without sequential chemotherapy were recruited. Each patient from the CRT group was matched to another patient treated with radiotherapy (RT) alone based on age, gender, pathological type, performance status, overall stage, stage method, Adult Comorbidity Evaluation-27 (ACE-27) score and RT technique, from the same institute and time period. We also recruited 101 young patients (age<65 years) as the referent group, which had been matched to the CRT group based on patient characteristics and treatment parameters. Treatment tolerability and toxicity were clarified, and treatment outcomes were calculated and compared among groups. RESULTS: CRT was feasible in elderly NPC patients, while a concurrent regimen of weekly cisplatin was more tolerable. Grade?3 acute toxicity in CRT group was similar with referent group, although it was significantly higher than the RT alone group (65.3% vs. 43.6%, P=0.002). Furthermore, patients with ACE-27 score?2 in the CRT group had significantly higher severe acute toxicity and dose reduction. Survival was poorer in elderly patients than the referent group. Compared to RT alone, CRT significantly improved the 5-year overall survival (OS: 54.6% vs. 39.3%, P=0.009), cancer-specific survival (CSS: 56.6% vs. 42.7%, P=0.022), disease-free survival (DFS: 51.6% vs. 30.2%, P=0.028) and locoregional relapse-free survival (LRRFS: 78.4% vs. 52.2%, P=0.003), but not distant metastasis-free survival (DMFS: 69.6% vs. 63.6%, P=0.669). However, CRT did not significantly improve 5-year OS (43.6% vs. 27.3%, P=0.893) or CSS (43.6% vs. 34.1%, P=0.971) in elderly NPC patients with ACE-27 score?2. CONCLUSIONS: CRT is feasible and effective in elderly patients with locoregionally advanced NPC without severe comorbidities. CRT should be used under serious consideration and be further tested in elderly patients with severe comorbidities. As such, it is essential to perform a comprehensive evaluation of pretreatment comorbidity status for all elderly NPC patients.

Dataset Information

The prognosis of neck residue nasopharyngeal carcinoma (NPC) patients: results from a case-cohort study.

Publications

The prognosis of neck residue nasopharyngeal carcinoma (NPC) patients: results from a case-cohort study.

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